Summary

Abstract

Introduction

Varus thrust of the knee is a dynamic increase of an often pre-existing varus angle and it is suspected to be a major reason for failure of anterior cruciate ligament (ACL) reconstruction. We performed open wedge high tibial osteotomy (HTO) and arthroscopic ACL reconstruction simultaneously on ACL deficient patients who had medial unicompartemtnal osteoarthritis (OA) and varus deformity. We aimed to evaluate clinical and radiological results after simultaneous open wedge HTO and arthroscopic ACL reconstruction in patients with ACL deficiency and medial unicompartemtnal OA with varus deformity.

Results

In all cases, there were no limitations on range of motion, 6 patients showed progression of medial unicompartmental OA. The Lysholm score was improved from 72.1 to 93.8 points (p=0.04). Mechanical axis was significantly corrected from varus 6.1 degrees to valgus 0.3 degrees (p=0.01), and tibial posterior slope did not show significant differences (p=0.71). Joint spaces were changed from 3.55mm to 3.84mm in the medial side, and 5.75 to 5.60mm in the lateral side, but it did not show significant differences (p>0.05). Also, there were no medial instabilities. Lachman test and pivot shift test were significantly improved and side to side difference using Telos® arthrometer, was improved from 7.75mm to 2.6mm postoperatively (p=0.03). For the complication, hypersensitivity on tibial anterolateral area was 3 cases and there was 1 case of pain on the incision area. There were no nonunion or fixation loss cases.